2025 Clinical Practice Guideline Update by the Infectious Diseases Society of America on the Treatment and Management of COVID-19: Abatacept

Nandita Nadig¹, Adarsh Bhimraj², Kelly Cawcutt³, Kathleen Chiotos⁴, Amy L Dzierba⁵, Arthur Y Kim^{6

7}, Greg S Martin⁸, Jeffrey C Pearson⁹, Amy Hirsch Shumaker^{10

11}, Lindsey R Baden^{6

12}, Roger Bedimo¹³, Vincent Chi-Chung Cheng¹⁴, Kara W Chew¹⁵, Eric S Daar¹⁶, David V Glidden¹⁷, Erica J Hardy¹⁸, Steven Johnson¹⁹, Jonathan Z Li^{6

12}, Christine MacBrayne²⁰, Mari M Nakamura^{21

22}, Laura Riley^{23

24}, Robert W Shafer²⁵, Shmuel Shoham²⁶, Pablo Tebas²⁷, Phyllis C Tien²⁸, Jennifer Loveless²⁹, Yngve Falck-Ytter^{10

11}, Rebecca L Morgan^{10

30}, Rajesh T Gandhi^{6

7}

Affiliations

¹ Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
² Division of Infectious Diseases, Houston Methodist Hospital, Houston, Texas, USA.
³ Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, Nebraska, USA.
⁴ Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia/University of Pennsylvania, Philadelphia, Pennsylvania, USA.
⁵ Department of Medicine, New York University Grossman School of Medicine, New York City, New York, USA.
⁶ Harvard Medical School, Boston, Massachusetts, USA.
⁷ Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
⁸ Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University, Atlanta, Georgia, USA.
⁹ Department of Pharmacy, Brigham and Women's Hospital, Boston, Massachusetts, USA.
¹⁰ Department of Medicine, Case Western Reserve University, School of Medicine, Cleveland, Ohio, USA.
¹¹ Department of Medicine, VA Northeast Ohio Healthcare System, Cleveland, Ohio, USA.
¹² Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
¹³ Department of Medicine, UT Southwestern/VA North Texas Health Care System, Dallas, Texas, USA.
¹⁴ Department of Microbiology, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China.
¹⁵ Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.
¹⁶ Department of Medicine, Harbor-UCLA Medical Center, Torrance, California, USA.
¹⁷ Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA.
¹⁸ Departments of Medicine and Obstetrics and Gynecology, Brown University, Providence, Rhode Island, USA.
¹⁹ Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.
²⁰ Department of Pharmacy, Children's Hospital Colorado, Aurora, Colorado, USA.
²¹ Antimicrobial Stewardship Program and Division of Infectious Diseases, Boston Children's Hospital, Boston, Massachusetts, USA.
²² Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.
²³ New York-Presbyterian Hospital/Weill Cornell Medical Center, New York City, New York, USA.
²⁴ Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York City, New York, USA.
²⁵ Department of Medicine, Stanford University, Palo Alto, California, USA.
²⁶ Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
²⁷ Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
²⁸ Department of Medicine, UCSF/VA San Francisco Health Care System, San Francisco, California, USA.
²⁹ Clinical Affairs and Practice Guidelines, Infectious Diseases Society of America, Arlington, Virginia, USA.
³⁰ Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.

PMID: 40923137
DOI: 10.1093/cid/ciaf354

2025 Clinical Practice Guideline Update by the Infectious Diseases Society of America on the Treatment and Management of COVID-19: Abatacept

Nandita Nadig et al. Clin Infect Dis. 2025.

. 2025 Sep 9:ciaf354.

doi: 10.1093/cid/ciaf354. Online ahead of print.

Authors

Affiliations

¹ Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
² Division of Infectious Diseases, Houston Methodist Hospital, Houston, Texas, USA.
³ Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, Nebraska, USA.
⁴ Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia/University of Pennsylvania, Philadelphia, Pennsylvania, USA.
⁵ Department of Medicine, New York University Grossman School of Medicine, New York City, New York, USA.
⁶ Harvard Medical School, Boston, Massachusetts, USA.
⁷ Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
⁸ Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University, Atlanta, Georgia, USA.
⁹ Department of Pharmacy, Brigham and Women's Hospital, Boston, Massachusetts, USA.
¹⁰ Department of Medicine, Case Western Reserve University, School of Medicine, Cleveland, Ohio, USA.
¹¹ Department of Medicine, VA Northeast Ohio Healthcare System, Cleveland, Ohio, USA.
¹² Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
¹³ Department of Medicine, UT Southwestern/VA North Texas Health Care System, Dallas, Texas, USA.
¹⁴ Department of Microbiology, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China.
¹⁵ Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.
¹⁶ Department of Medicine, Harbor-UCLA Medical Center, Torrance, California, USA.
¹⁷ Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA.
¹⁸ Departments of Medicine and Obstetrics and Gynecology, Brown University, Providence, Rhode Island, USA.
¹⁹ Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.
²⁰ Department of Pharmacy, Children's Hospital Colorado, Aurora, Colorado, USA.
²¹ Antimicrobial Stewardship Program and Division of Infectious Diseases, Boston Children's Hospital, Boston, Massachusetts, USA.
²² Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.
²³ New York-Presbyterian Hospital/Weill Cornell Medical Center, New York City, New York, USA.
²⁴ Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York City, New York, USA.
²⁵ Department of Medicine, Stanford University, Palo Alto, California, USA.
²⁶ Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
²⁷ Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
²⁸ Department of Medicine, UCSF/VA San Francisco Health Care System, San Francisco, California, USA.
²⁹ Clinical Affairs and Practice Guidelines, Infectious Diseases Society of America, Arlington, Virginia, USA.
³⁰ Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.

PMID: 40923137
DOI: 10.1093/cid/ciaf354

Abstract

This article provides a focused update to the clinical practice guideline on the treatment and management of patients with coronavirus disease 2019 (COVID-19), developed by the Infectious Diseases Society of America. The guideline panel presents a recommendation on the use of abatacept in hospitalized adults with severe or critical COVID-19. The recommendation is based on evidence derived from a systematic literature review and adheres to a standardized methodology for rating the certainty of evidence and strength of recommendation according to the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach.

Keywords: COVID-19; SARS-CoV-2; abatacept; guideline.

© The Author(s) 2025. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.

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Conflict of interest statement

Potential conflicts of interest. Evaluation of relationships as potential conflicts of interest (COI) is determined by a review process. The assessment of disclosed relationships for possible COIs is based on the relative weight of the financial relationship (ie, monetary amount) and the relevance of the relationship (ie, the degree to which an association might reasonably be interpreted by an independent observer as related to the topic or recommendation of consideration). No panelists had COIs directly related to abatacept. The following panelists have scientific advisory/consultant roles not related to the topic of COVID-19 with indicated companies: R. B. with Merck and Gilead, E. S. D. with Gilead, D. V. G. with Merck and Gilead, S. S. with Pfizer (concluded), P. T. with Merck, and R. G. with Merck. The following panelists have scientific advisory/consultant roles related to COVID-19 but not severe/critical COVID-19 with indicated companies: R. B. with Shionogi, K. C. with Pardes Biosciences (concluded), A. Y. K. with Shionogi, S. S. with Adamis and Immunome (concluded), and P. T. with Shionogi. J. C. P. had a scientific advisory/consultant role (concluded) with InflaRx related to vilobelimab for critical COVID-19. No disclosures were reported for all other authors (the majority of panelists), including chair and vice chair. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

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2025 Clinical Practice Guideline Update by the Infectious Diseases Society of America on the Treatment and Management of COVID-19: Abatacept

Affiliations

2025 Clinical Practice Guideline Update by the Infectious Diseases Society of America on the Treatment and Management of COVID-19: Abatacept

Authors

Affiliations

Abstract

Conflict of interest statement

Grants and funding

LinkOut - more resources

Full Text Sources

Miscellaneous